There are over a hundred strains of HPV and they are each given a designated number eg HPV 6 or HPV 16 or HPV52. Now, HPV strains that cause warts will NOT cause cancers and HPV strains that cause Cancer will NOT cause warts.

HPV are attracted to and are able to live only in certain cells in the body called squamous epithelial cells. These cells are found on the surface of the skin and on moist surfaces (called mucosal surfaces) like:

The vagina, anus, cervix, vulva (around the outside of the vagina)

The inner foreskin and urethra of the penis

The inner nose, mouth, throat

The trachea (the main breathing tube) and bronchi (smaller breathing tubes branching off the trachea)

The inner eyelids

Hence infection of these surfaces causes warts and cancerous cells to form.

GARDASIL 9 helps prevent infection caused 9 different types of HPV, hence it’s appropriately named Gardasil 9. Out of the 9 HPV type in the vaccine, two are for wart prevention (HPV 16 and 18) and the remaining seven are for Cancer prevention (HPV 16, 18, 31, 33, 45, 52, 58).

With regards to cancers, HPV causes most cases of cervical cancer, as well as many vaginal, vulvar, anal, penile, and oropharyngeal cancers (cancers of the throat and tongue).

How is this vaccine different from the older vaccines Cervarix and Gardasil?

What about men? How is Gardasil 9 important in men?

Let’s break this up into 2 major groups of men based on sexual activity. Men who engage in penetrative anal sex and men who do not.

Men who engage in penetrative anal sex and are on the receiving end, are generally at greater risk of HPV related anal cancer as the HPV deposits on the anal mucosal surfaces.

Early vaccination in boys or young men helps to prevent this increased risk of anal cancers regardless of sexual preferences in the future. Unlike women, there is no current well-established guideline approved screening program like pap smear for men who engage in anal sex.

Men who do not engage in receptive anal sex can still benefit from the vaccine. The vaccine can lower their risk of oral cancers and penile cancers. HPV can be deposited on the penis during vaginal sex or during oral sex. Similarly, HPV can also be deposited in the oral cavity during oral sex.

Many heterosexual men might ask, ‘Considering HPV more commonly causes Cervical cancer, it seems to be a woman’s problem not so much a man’s.’

Think about it though, the more men there are vaccinated, the bigger the pool of immune individuals and hence reducing the risk of transmission of HPV to women, in whom HPV poses a larger risk of life-threatening cancers. This is called the “herd immunity”.

And conversely, as more women get vaccinated, more men have conferred the protection from the “herd immunity”, as the prevalence of HPV falls, reducing a man’s risk of HPV related diseases.

So we should also encourage our boys and men to get vaccinated with GARDASIL 9to reduce the overall risk and incidence of HPV related cancers and warts. In countries like Australia, HPV vaccination has been introduced into their National Immunization Program-sponsored school-based initiative, to widely vaccinate boys aged 12 to 13.

How is the vaccine administered and what is the dosing schedule?

GARDASIL 9 is a tiny injection given into a muscle on your arm or your thigh or your buttocks.

3 doses are required for complete vaccination. The 3 doses should ideally be spread out across a period of 6 months. For examples, if you take your first dose today, your 2nd dose will be in 2 months from today and your 3rd dose will be 6 months from today.

Even if you do forget or delay your subsequent doses, effective immunity can still be achieved as long as you complete all 3 doses within a 12 months period.

With GARDASIL 9, do women then still need to do their pap smears?

Yes. Although GARDASIL 9 covers for more HPV type than the older vaccines, it still does not cover for ALL the strains of cancer-causing HPV only 7 of them. And remember there are 15 known strains of HPV that cause cancer and perhaps more that we are not yet aware of.

Pap smear should be done at least once every 3 years. If your pap smears are abnormal your doctors might ask you to return every 6-12 months to repeat your pap smear for purpose of closer monitoring.

**Currently GARDASIL 9 approval for use with Medisave for Singaporean and PRs 26 yrs or younger is still pending

If you are interested in getting the HPV vaccine or learning more, please visit Our Clinics.

As of now, stocks of Gardasil 9 are in shortage worldwide. The earliest estimate is Apr/ May 2018. My suggestion is if you are keen for the vaccination, please make a deposit with any of the clinics so that we can place the order for you and inform you when the stocks are in.

The reason why there is a recommended age for the Gardasil vaccine is due to the fact that that was the age group that the studies were made. There is no evidence currently for or against vaccination in older age groups.

I would like to book an appointment for the treatment for HpV vaccine gardasil 9.
Im a 1993 born female. but im currently overseas now and back to Singapore till 27th Feb. May I know the appointment procedures?

Hi Vicky, at the current moment Gardasil 9 is low on stock throughout the country, and we are awaiting further updates from the supplier. As such, we are only able to reserve stock for patients who have made payment in advance. Please write in to us at doctor@drtanandpartners.com and we can provide further information on the process.

We do have Gardasil 9 available in our central pharmacy but you will be required to make payment first to reserve the dose and have it delivered to our clinic within 7 days. There is currently a shortage from the supplier in the country so we are only able to prioritize stock for patients who have made pre-payment. Please contact us for further information if needed.

Due to current supply shortages from the manufacturer, our cost prices have increased and the Gardasil 9 vaccine is now S$248 per injection. Please contact us for details on payment and reservation of stock.

The vaccine will not be able to treat the warts, only prevent other HPV types. However, we do have treatments for warts that you would benefit from. It is best to visit us for a proper consult and evaluation.